Provider Demographics
NPI:1770256307
Name:PATTERSON, JORDAN CURTIS (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:CURTIS
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MISS
Other - First Name:JORDAN
Other - Middle Name:ELIZABETH
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, RBT
Mailing Address - Street 1:814 TYVOLA RD STE 126
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-3539
Mailing Address - Country:US
Mailing Address - Phone:980-785-1113
Mailing Address - Fax:980-785-1114
Practice Address - Street 1:139 E COURT ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1703
Practice Address - Country:US
Practice Address - Phone:980-785-1113
Practice Address - Fax:980-785-1114
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-23-69713103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst